Posture and preventing back pain with Physiotherapist led Pilates

We all come in different shapes and sizes, and might have inherited varying physical characteristics so how do we know what good posture is? As qualified Chartered Physiotherapists we spend 80% of our working lives assessing, treating and prescribing rehabilitation exercises for varying conditions and we are very rarely aiming to make our patients fit the ideal perfect posture because we all have a different idea of what this is. Instead we look to achieve a balanced posture, with joints being comfortably held in a neutral (i.e.: ‘middle’ position) and muscles working equally with their opposite partner.

When assessing posture, we are initially looking to see how much effort is being used to simply stand up. Some joints might be held slightly bent (typically hips might become tight with too much sitting) whilst other joints are overly locked out straight (knees have a tendency to do this). We also look to see if some muscle groups over working (such as shoulders being kept hunched up with stress) and if other muscles not doing their fair share (weak abdominals might result in an overly arched lower back). We also may assess balance to look at factors such as one side being favoured over the other and if the pelvis can be held level when balancing on one foot. Recognising these problem areas allows us to then prescribe the right exercises to start correcting them.

Assessing the spine is a good place to start because everything is attached ultimately to this structure.

A neutral spine means keeping the gentle forward and backward curves in place whilst we are stood upright. It is important to maintain these curves as they help to dissipate any gravitational stresses that travel up and down our spines with normal day-to-day activity. However over time we may lose these curves: an occupation that involves sitting for prolonged periods may tighten hamstrings, which can tip our pelvis backwards, flattening the lower back curve. On the other hand, abdominals weakened by weight gain or pregnancy might result in an overly exaggerated the lumbar spine’s curve.

Our physiotherapist Pilates instructors gained their qualifications at the Australian Physiotherapist and Pilates Institute. Modified Pilates, as taught by our physiotherapists, starts by teaching you how to recognise how we can hold our spine in a neutral position. We then show you how to recognise the feeling when you switch on the right type of muscles that are required to hold us in place – these are our postural muscles – also commonly known as our ‘core’.

Our body has deep stabilising muscles around most of our joints. The core muscles that stabilise our lower back consist of 4 sets of muscles – transverse abdominis at the front, multifidus in the back, the pelvic floor on the bottom and our breathing muscle, the diaphragm on the top. When these muscles work in unison they gently squeeze around our spine, holding it in place with our pelvis allowing safe and controlled movement in all directions. Latest research has shown that training these muscles can help to reduce back pain.

Everybody has a functioning core or they would not be able to stand or even sit upright! However it is necessary to recognise the sensation of it drawing in, in order to be able to help it get stronger. Otherwise it is likely that other muscles will work too hard in its place and then there is a risk of injury. We realise that we learn in different ways so we use a variety of teaching methods and cues to help you understand what’s working in your body, ranging from demonstration, visual imagery to verbal physical description and hands-on palpation.

During Modified Pilates classes and private one-to-one sessions in the clinic you are then shown a progression of exercises working top to toe, whilst maintaining the core recruitment, making you gradually fitter and stronger.

When the spine and pelvis are held steady, the other power muscles that are attached to them have a strong stable base to work from, making walking, running and all other movements easier, more powerful and efficient. And this is how Pilates helps us to better manage sciatica, back and neck pain as well as other conditions such as arthritis and fibromyalgia.

I have seen a few physios and a chiropractor over the past ten years and Liz is the only person who identified that I had a falling arch and not only recommended the right orthotics with a raise but also suggested some compromises so I could still wear a raise with holiday footwear. She also showed me some exercises specific to my problems (not just some print out of generic back exercises). Through her treatment, the exercises and orthotics I feel I have a long term solution for the first time in 25 years (since an accident) that has actually also fixed knee and foot pain and neck pain and headaches that I never realised were related. I would highly recommend her as someone who genuinely tries to help fix the problem not just temporarily relieve pain.

Couldn’t ask for a better team to help get me back on my feet! Liz is very patient and motivating! The reception team are extremely helpful and go above and beyond to help with any issues you may have. I am so glad I found Marple Physio to help me through a very difficult time in my life. Thank you all!

Top marks for everything. Prior to my knee replacement surgery, Liz has been working hard to get me in the best possible condition. Her expertise and her pleasant manner have made the sessions very rewarding. I would thoroughly recommend this practice in every way.

I was incredibly impressed with my treatment at Marple Physio. They took the time to listen to what the cause of the issue was and then looked at different treatments to resolve the issue. The treatment must have worked as I was able to complete the half marathon that I’d been training for (relatively) pain free, having only been able to run a few kilometres at most prior to my treatment. I have since recommended Marple Physio to a number of people.

In over 65 years I had never visited or needed to visit a Physio. That was until firstly I had a knee problem and the for the first time in my life a back problem. Both down to excessive golf. Well Elizabeth who treated me was wonderful. She identified the problems immediately and with the minimum number of visits cleared my problems. Lovely manner and would not hesitate to recommend.

Big thanks to Marple Physio for sorting out my sciatica. After months of suffering you diagnosed the cause, (tight muscle) and arranged treatment. Wouldn’t hesitate in recommending you!

Thoroughly satisfied with treatment. My daughter Grace had a sports problem with her foot which was extremely distressing for her. She was unable to get an urgent appointment with the lower limb specialist but was seen by the team at Marple Physio – who were fantastic. Helpful, reassuring and made some great suggestions and gave exercises which have been really beneficial. Her problem has been hard to diagnose but the help and treatment has been great and thank you for strapping Grace’s foot for a big running event. It worked and she was delighted with the strapping. I would highly recommend Marple Physio and the specific tailored treatment offered. Reception staff also very nice.

I don’t usually comment on these things but I thought I had to. The Marple team were simply wonderful. I have had lower back pain for 15 years or so and had given up hope of being pain free. Marple Physio listened very carefully to my problems. I then was put through my paces including working my feet and toes. I felt light after the first session and by week three I was nearly pain free. Magic, simply magic.

I found the service and treatment excellent. I would definitely recommend Marple Physio to others and would use them again should the need ever arise. Many Thanks.

I had a persistent calf injury and had already seen several other physios without success. I was recommended Marple Physio by a friend from Stockport Harriers. They were very accommodating when I called to book an appointment and Liz managed to diagnose and sort the calf injury in 3 sessions. I left pain free and with strict instructions to continue my stretching homework to avoid further calf issues. I wouldn’t hesitate to recommend them.

Marple Physio are really excellent. They helped me through a complicated hip injury – adjusting treatments and exercises regularly after listening carefully to my feedback. I’ve just completed the London Marathon and it’s all thanks to Liz and the team. I wouldn’t hesitate to recommend them to others.

Wonderful to find a physio who spoke to me like a person and not an idiot, clearly explained my injury and went through treatment options along with her recommendations. Would definitely recommend to anyone – especially those who like to try to understand the physiology of their problem.

Fabulous, a true assessment of what I needed and how I could achieve it, with a personally tailored plan that fitted my lifestyle and abilities.

I was referred to you from my specialist at the Alexandra Hospital. I was really pleased with my treatment and the help I was given. I have finally had treatment that works for me. Will definitely come back for help if required. Many thanks.

Unfortunately for me, I have had quite a few back problems over the past few years. Fortunately, Marple Physio is nearby and Liz and the team have done a fabulous job of unpeeling all the layers and getting to the root of the problem each time. Being treated with a combination of manipulation, acupuncture and Pilates exercises means I now have a much stronger core and I know how to keep it that way! A big thank you to you all.

I am very pleased with the fantastic treatment I received from Liz for headaches. She was very professional and friendly and I would happily recommend her to others.

Every time I came for an appointment I went away very satisfied. All the staff are very friendly and professional. I would recommend Marple Physio and they will be my first choice if I need more treatment.

After six weeks of neck and shoulder pain, it was a total relief to receive professional and expert advice with successful treatment over four sessions.

I use Marple Physio for my physio, podiatry and Pilates needs, the service has always been both professional and caring. I am greeted with a friendly welcome and I feel the treatment is continually tailored to my needs.

Elizabeth’s expert diagnosis and treatment which included massage, acupuncture and targeted Pilates exercises resolved a backache and sciatica problem I have had for several years. Many thanks to Liz and the team.

Myself and my 16 year old daughter have had to use Marple Physio several times for various injuries. The service is excellent. I have no hesitation in recommending them. The quality of care is outstanding. They are friendly team and professional and have always been able to sort out our various aches and pains. If ever I have any musculoskeletal problems, I would always go straight to Marple Physio rather than see a GP. They have a far wider and much more suitable range of care options and offer a far more thorough service than I would ever get in a 10min appointment at the GP.